On hamburgers and health care

By Rob Eder

This is going to be a big year for retail clinics because this is going to be the year that payers really begin to engage with retail-based care on a meaningful level.

At its annual Analyst Day Dec. 20, CVS Caremark executives unveiled a new program that integrates its retail clinic and pharmacy-benefit manager offerings. “Caremark is now offering an exciting new program where clients have the opportunity to change their benefit structure to substantially reduce and, in some cases completely eliminate, co-pays at MinuteClinic in order to lower overall healthcare costs,” Andrew Sussman, president of MinuteClinic and SVP and associate chief medical officer for CVS Caremark, told analysts.

Key to that is the ability of the clinics to move beyond acute care. “Providing access to both acute and chronic care for the 60 million Caremark members is an important integration sweet spot for our company,” Sussman said. Non-acute care visits are the fastest-growing segment of MinuteClinic’s business, he said, expected to reach 25% of its mix over the next five years — services like chronic disease monitoring, point of care testing and physical exams.

This news was in sharp contrast to the noise that came out of the Senate antitrust committee hearing Dec. 6, where Express Scripts CEO George “I-can’t-stop-certain-pharmacies-from-going-out-of-business” Paz, in making his case for the ESI-Medco deal, suggested that the U.S. market was oversaturated with 68,000 pharmacies versus about 10,000 McDonald’s locations or 13,000 Starbucks locations. That’s just a stupid analogy as it leaves out the tens of thousands of fast food locations those two companies compete against. It also suggests America needs more options for hamburgers than health care.

In contrast to CVS Caremark, which sells an integrated offering of services — CVS stores, the rest of its network, mail if you want it, specialty if you need it and now it has come up with an innovative way to bundle its clinics into the offer — ESI is kind of a one-trick pony. And if the Federal Trade Commission doesn’t approve this deal, in the new world of health care where outcomes matter most, it could become a dinosaur.

Rob Eder is the editor in chief of The Drug Store News Group, publishers of Drug Store News, DSN Collaborative Care and Specialty Pharmacy magazines. You can contact him at reder@lf.com.